Integrating plant-based diets into the One Health approach

Abstract

The interconnected crises of climate change, biodiversity loss, antimicrobial resistance, zoonotic diseases emergence, animal welfare concerns, and the rising burden of non-communicable diseases require food-system responses that extend beyond individual nutrition. This narrative review synthesizes evidence on plant-based and plant-forward dietary transitions within the One Health framework, with emphasis on their implications for human, animal, and environmental health. The reviewed evidence indicates that reducing reliance on animal-derived foods, particularly those from intensive livestock systems, can lower zoonotic spillover risk, reduce antimicrobial use in animal agriculture, and decrease exposure to food-system drivers of antimicrobial resistance. Well-planned plant-based diets may also support cardiometabolic health and reduce risk factors associated with major non-communicable diseases, including cardiovascular disease, type 2 diabetes, obesity, and some cancers. From an environmental perspective, plant-based dietary shifts can reduce greenhouse gas emissions mainly by decreasing demand for ruminant livestock, lowering methane emissions from enteric fermentation, reducing manure-related nitrous oxide emissions, decreasing feed-crop production, and limiting land-use change associated with grazing and animal feed cultivation. They can also reduce pressure on forests, freshwater resources, nutrient pollution, and biodiversity, although these benefits depend on which plant foods replace animal products, how they are produced, their degree of processing, and whether sourcing and land-use policies prevent environmental burden shifting. The review also highlights important challenges, including cultural attachment to meat-based diets, affordability and access, agricultural capacity, nutritional planning, and policy structures that continue to favor animal production. To translate these findings into real-world benefits, plant-forward diets should be implemented through gradual, culturally acceptable dietary changes supported by nutrition education, updated dietary guidelines, public procurement, incentives for legumes and other sustainable plant-based foods, responsible sourcing, and the integration of food policy into climate, biodiversity, antimicrobial resistance, and public health strategies. In this form, plant-based dietary transitions can function as a practical One Health intervention that simultaneously supports human health, animal welfare, and planetary resilience.

1 Introduction

The contemporary global health landscape faces unprecedented interlinked challenges that transcend the boundaries of human medicine. Climate change, biodiversity loss, antimicrobial resistance, and the increasing burden of non-communicable diseases (NCDs) have led to the adoption of holistic frameworks that acknowledge the interconnectedness of human, animal, and environmental health (Poore and Nemecek, 2018; Springmann et al., 2020; Craig et al., 2021). Among these, the One Health approach has gained particular prominence as a multidisciplinary, integrative paradigm that aims to achieve optimal health outcomes by recognizing that the wellbeing of humans, animals, plants, and ecosystems is closely intertwined (EFSA, 2023). Traditionally, One Health has emphasized zoonotic diseases, food safety, and antimicrobial resistance. However, its scope has been expanding toward broader determinants of health, including food systems and dietary patterns, domains that directly influence and are influenced by the shared health of all species and the planet (FAO, UNEP, WHO, and WOAH, 2022). Dietary habits are among the most powerful levers shaping both population health and environmental sustainability. Current global food systems are responsible for approximately one-third of anthropogenic greenhouse gas emissions, massive land-use change, freshwater depletion, and nutrient pollution (Poore and Nemecek, 2018; Mekonnen and Gerbens-Leenes, 2020; Crippa et al., 2021; Mandouri et al., 2025). At the same time, suboptimal diets contribute to millions of premature deaths each year and substantial economic losses, primarily through NCDs such as cardiovascular diseases, diabetes, and certain cancers (Afshin et al., 2019; Xu et al., 2025). Animal-based food production, particularly red meat and dairy, plays a disproportionate role in these adverse outcomes, accounting for high resource use, methane emissions, and ethical concerns associated with intensive livestock farming (González et al., 2020; von Greyerz et al., 2023). As the world’s population continues to grow, the challenge of ensuring nutritious, affordable, and sustainable diets for all has become one of the defining public health and ecological issues of the 21st century (FAO, IFAD, UNICEF, WFP, WHO, 2023).

In this context, plant-based diets have emerged as a promising, evidence-based dietary pattern that aligns human health benefits with environmental protection and animal welfare–encompassing vegetarian (consuming eggs and dairy products, excluding meat and fish), vegan (plant-based diet, excluding meat, fish, eggs and dairy products), and flexitarian variants (i.e., a predominantly plant-based diet allowing occasional consumption of meat or other animal products), emphasizing foods derived primarily from plants, such as whole grains, legumes, fruits, vegetables, nuts, and seeds, while reducing or eliminating animal products (Carey et al., 2023). A plant-based diet refers to a dietary pattern in which an individual has made a deliberate and sustained decision to exclude specific categories of animal-derived foods from their habitual diet (Craig et al., 2021). In contrast, a plant-forward diet is understood as a flexible dietary approach that emphasizes plant-derived foods without requiring the consistent exclusion of animal products. Rather than representing a fixed dietary commitment, it reflects an awareness of the environmental, health, and animal welfare implications associated with animal-derived foods. These are definitions developed for the purposes of this review, which aims to highlight that even limiting the consumption of food of animal origin can contribute to improving the environment, human health, and animal welfare.

Substantial evidence suggests these diets may be associated with lower health risks and environmental benefits (Willett et al., 2019). However, their integration into the One Health framework remains conceptually underdeveloped and operationally fragmented. Recent publications have begun to examine plant-based diets within a One Health framework (Burke et al., 2025; Hosseini et al., 2025; Lal, 2025), although to our knowledge, there remains no comprehensive narrative review that synthesizes evidence across the major One Health domains, including human health, environmental sustainability, animal welfare, zoonotic disease risk, and antimicrobial resistance within a single conceptual framework. This review aims to address that gap by providing a broad, interdisciplinary synthesis of the evidence and highlighting the interconnections among these domains. Although the environmental and health benefits of dietary transitions are well-documented, they are seldom analyzed through a unified lens that captures cascading effects across human, animal, and ecological domains. One Health provides a powerful conceptual scaffold for such synthesis, enabling a multidimensional understanding of how dietary choices shape, and are shaped by, complex interactions between food production systems, disease ecology, and planetary processes–for instance, reducing livestock density not only mitigates greenhouse gas emissions but also lowers the risk of zoonotic spillovers, antibiotic use in animal husbandry, and habitat destruction (FAO, UNEP, WHO, and WOAH, 2022). Similarly, diversifying agricultural systems toward more plant-based production can enhance soil health, promote biodiversity, and contribute to ecosystem resilience–reinforcing the ecological foundation upon which human and animal health depend (Poore and Nemecek, 2018).

This narrative review was conducted with Google Scholar as the primary literature database. The literature search was performed between September 2025 and March 2026. Search queries combined the terms “One Health” or “plant-based diet” using the Boolean operators AND and OR with the following topic keywords: “antimicrobial resistance”, “infectious disease”, “non-communicable disease”, “animal welfare”, “water resources”, “climate change”, “deforestation”, “biodiversity”. The review primarily included peer-reviewed articles published between 2020 and 2025 to ensure that the evidence reflected current knowledge. However, a limited number of earlier publications were included when they were important to the topic. Studies directly relevant to the review objectives were included, while articles that did not meet the review objectives were excluded. Systematic reviews, meta-analyses, and peer-reviewed journal articles published within the last 5 years were preferred for quality assessment.

The relevance of dietary patterns to the One Health agenda has gained urgency in light of recent global crises. The COVID-19 pandemic did not merely represent an infectious disease emergency; it also exposed vulnerabilities at the human–animal–environment interface, including risks associated with habitat encroachment, wildlife-livestock interfaces, globalized food supply chains, and feedback loops between environmental degradation and emerging infectious diseases. Similarly, climate-induced disruptions, such as heatwaves, droughts, floods, and wildfires, have revealed the vulnerability of food systems and the importance of dietary patterns that support both human health and ecological resilience (Lawler et al., 2021; Shepon et al., 2023). In this context, plant-based and plant-forward diets can be considered not only as individual nutritional choices, but also as potential components of One Health risk management (Nelson et al., 2016). By improving dietary quality and reducing major cardiometabolic risk factors, such diets may strengthen population health resilience; by lowering reliance on intensive livestock production, they may reduce pressures linked to zoonotic spillover, antimicrobial use, greenhouse gas emissions, land degradation, water consumption, and biodiversity loss.

The guiding premise of this narrative review is that well-planned plant-based and plant-forward dietary transitions, when supported by appropriate nutritional, agricultural, and policy measures, can serve as a cross-cutting One Health strategy that simultaneously addresses human health, animal welfare, environmental sustainability, and food-system resilience. At the conceptual level, we hypothesized that reducing reliance on intensive animal-based food systems would generate synergistic benefits across One Health domains by lowering pressures related to emerging infectious diseases, antimicrobial resistance, non-communicable diseases, greenhouse gas emissions, land-use change, water consumption and pollution, biodiversity loss, and animal welfare concerns. Therefore, this review synthesizes evidence linking plant-based dietary transitions with major One Health domains, including emerging infectious disease prevention, antimicrobial resistance mitigation, non-communicable disease prevention, animal welfare, climate mitigation, land use, water resources, and biodiversity preservation. It also identifies implementation challenges and barriers and proposes integrative pathways for research, policy, and practice. Framing plant-based diets through this One Health and risk-management perspective may help translate dietary change into actionable strategies that support health equity, ecological stewardship, and long-term planetary resilience.

2 One Health approach

The One Health approach seeks to sustainably balance and optimize the health of people, animals, and ecosystems through integrated multisectoral collaboration. According to the One Health High-Level Expert Panel (OHHLEP), One Health requires the close collaboration of human and veterinary medicine, public health, ecology, agriculture, and social sciences, along with the meaningful involvement of communities and other stakeholders (Mettenleiter et al., 2023). Conceptually, it is commonly structured around three core and interdependent pillars: human health, animal health, and environmental health. Human health includes infectious diseases, non-communicable diseases, nutrition, food safety, and population resilience. Animal health includes the health and welfare of farmed animals, companion animals, wildlife, and aquatic species, as well as the prevention and control of diseases that may circulate between animals and humans. Environmental health includes the integrity of ecosystems, biodiversity, climate stability, soil and water quality, and the ecological conditions that regulate pathogen transmission. This approach recognizes that the health of humans, domestic animals, wildlife, plants, and the wider environment is interdependent and shaped by shared social, ecological, and economic systems. Food production and dietary patterns are particularly relevant within this framework because they simultaneously affect human nutrition, animal health and welfare, and environmental pressures. Accordingly, dietary transitions can be considered not only as nutritional changes, but also as potential One Health interventions.

Within this framework, several operational areas are particularly relevant to food-system transformation: zoonotic diseases, antimicrobial resistance, food safety and food security, and climate-related impacts on disease ecology. Threats emerging at the human–animal–environment interface, particularly zoonotic diseases, continue to pose major global risks. Drivers such as agricultural intensification, land-use change, biodiversity loss, pollution, and climate change increase the likelihood of pathogen spillover and amplify the impacts of health emergencies. Antimicrobial resistance (AMR) further underscores the need for coordinated action across sectors, as resistant pathogens circulate among humans, animals, food systems, and the environment. Food safety and food security are also central One Health concerns, because the way food is produced affects nutritional adequacy, pathogen exposure, chemical contamination, animal welfare, ecosystem integrity, and the stability of food supply (Garcia et al., 2020). Climate change further modifies these risks not only through extreme weather events, but also through biotic and vector-mediated pathways, including changes in the distribution, abundance, seasonality, and competence of vectors such as mosquitoes and ticks, as well as changes in reservoir-host ecology and pathogen survival (de Souza and Weaver, 2024; Abbasi, 2026; Fanzo et al., 2025). These interconnections are directly relevant to dietary transitions because changes in food demand may influence production intensity, land and water use, antimicrobial use, animal populations, and the environmental footprint of food systems. Despite the clear relevance of these interconnected risks, progress in One Health implementation has often been limited by fragmented governance, siloed data systems, and insufficient long-term investment (FAO, WHO, UNEP, WOAH, 2023).

To strengthen global governance, the One Health High-Level Expert Panel (OHHLEP) was established in 2021 by four major organizations: FAO, UNEP, WHO, and WOAH. OHHLEP provides scientific advice and guidance to support global One Health policymaking. In response to international calls to prevent future pandemics and promote sustainable health through the One Health approach, the Quadripartite has developed the One Health Joint Plan of Action (2022–2026) (FAO, UNEP, WHO, and WOAH, 2022). The Plan comprises six interlinked action tracks: (1) fostering One Health capacities, (2) addressing emerging and re-emerging zoonotic threats, (3) managing endemic zoonoses, (4) strengthening food safety systems, (5) combating antimicrobial resistance, and (6) integrating environment, biodiversity, and climate considerations into health decision-making (Springmann et al., 2020). Together, these actions provide a coordinated framework for building resilient systems capable of preventing, detecting, and responding to health threats, including those with pandemic potential (Springmann et al., 2020; FAO, UNEP, WHO, and WOAH, 2022; FAO, WHO, UNEP, WOAH, 2023).

For the purpose of this review, global One Health implementation can be considered through three complementary pathways. These pathways are adapted from the broader implementation domains emphasized in the Quadripartite One Health Joint Plan of Action and its implementation guidance and are used here as an analytical structure for examining dietary transitions, rather than proposed as a new independent One Health framework (FAO, WHO, UNEP, WOAH, 2023). The first pathway includes policy, legislation, advocacy, and financing, such as dietary guidelines, agricultural subsidies, antimicrobial stewardship, climate and biodiversity strategies, public procurement policies, and financial support for sustainable food production. The second pathway concerns organizational-level implementation, including multisectoral coordination among public health, veterinary, agricultural, environmental, educational, and food-system institutions, as well as integrated surveillance and risk-management systems. The third pathway involves data, science, evidence, and education, including research synthesis, monitoring of health and environmental outcomes, public communication, professional training, and nutrition education. These pathways provide an operational structure for translating One Health principles into practice and for interpreting the role of dietary transitions in the following chapters.

Food and food-production systems constitute a central domain for the application of One Health principles (Bremner et al., 2023; Nguyen-Viet et al., 2025). How food is produced affects not only the safety and nutritional value of the final product but also the health and welfare of animals, the resilience of plants, and the degree of environmental contamination. Conversely, environmental degradation, animal and plant health, and contamination along the production chain directly affect food safety and public health outcomes. Integrated surveillance of pathogens and antimicrobial resistance across farms, wildlife populations, food-processing environments, and human health systems is therefore essential (Bremner et al., 2023).

Dietary choices also play an increasingly recognized role in the One Health framework (Paris et al., 2022; Burke et al., 2025). Shifts toward more plant-based diets can reduce pressures on land and water resources, lower greenhouse gas emissions, and support animal welfare, thereby helping to mitigate environmental drivers of future health threats (Paris et al., 2022). Within a broader One Health strategy, such nutritional transitions complement efforts to strengthen sustainable food systems. They are also relevant to the three implementation pathways outlined above: they can be supported through policy and financing instruments, operationalized through institutions responsible for food procurement, health promotion, agriculture, and environmental protection, and evaluated through data, scientific evidence, monitoring, and education (Paris et al., 2022; Burke et al., 2025). This linkage illustrates why dietary transitions should be understood as a cross-sectoral implementation issue rather than solely as a matter of individual food choice.

The conceptual integration of plant-based dietary transitions within the One Health framework is illustrated in Figure 1, which summarizes how dietary shifts away from intensive animal-based food systems and toward well-planned plant-forward patterns may influence interconnected domains of human health, animal welfare, and environmental sustainability. These pathways, discussed in our work, include potential reductions in zoonotic spillover risk, antimicrobial use, non-communicable disease burden, greenhouse gas emissions, land and water pressures, pollution, biodiversity loss, and animal welfare concerns. This figure should be interpreted as a conceptual framework rather than a deterministic causal model, because the magnitude of these benefits depends on dietary composition, production systems, sourcing, governance, and implementation context.

FIGURE 1

3 Plant-based diets and human health

3.1 Plant-based diets in One Health strategies for emerging infectious disease prevention

The One Health approach seeks to prevent emerging infectious diseases by addressing their underlying ecological, environmental, and socio-economic drivers (Gebreyes et al., 2014). Its key aims include reducing the interfaces and risk factors that facilitate pathogen spillover between animals, humans, and ecosystems; promoting sustainable agricultural and food system practices that limit the emergence and spread of zoonotic agents; and protecting biodiversity and ecosystem integrity, which serve as natural buffers against disease transmission. By integrating human, animal, and environmental health considerations, One Health aims to develop resilient systems that can prevent, detect, and mitigate zoonotic threats before they escalate into large-scale outbreaks (Winkler et al., 2025). This integrative framework recognizes that health security cannot be achieved in isolation: the same forces driving ecological imbalance, such as deforestation, wildlife trade, agricultural intensification, and climate change, also shape the epidemiological landscape of infectious disease risk.

Zoonotic diseases can be transmitted through various means, including foodborne, waterborne, vector-borne, direct contact with animals, indirect contact via fomites, or environmental contamination. They are caused by pathogens such as viruses, bacteria, parasites, or fungi that can cross species barriers and infect humans. Examples include Rift Valley fever virus, MERS-CoV, Ebola virus, and avian influenza viruses such as H5N1 (FAO, 2025). Importantly, zoonotic risks are closely tied to intensive animal agriculture, where high-density livestock production, close human–animal contact, and large-scale animal transportation create optimal conditions for pathogen spillover. It is estimated that 60% of all human pathogens and approximately 75% of emerging human infectious diseases are of zoonotic origin (Zhang et al., 2024). Intensive farming, characterized by the confinement of large numbers of animals at high stocking densities, often with limited genetic diversity and frequent animal turnover, can facilitate rapid pathogen amplification and transmission once a pathogen enters a facility, while sustained circulation may also increase opportunities for genetic change and adaptation (Mennerat et al., 2010; Stel, Eggers, and Alonso, 2022).

Furthermore, environmental degradation, including habitat destruction, biodiversity loss, and ecosystem disruption, can increase opportunities for zoonotic disease emergence by altering interactions among wildlife, domestic animals, and humans. A spillover event occurs when a pathogen maintained in an animal reservoir crosses the species barrier and infects humans. Such events are rarely attributable to a single factor; rather, they usually result from interactions among ecological change, agricultural practices, human behavior, pathogen characteristics, and host susceptibility (Gwenzi et al., 2022; Plowright et al., 2024; Yoh et al., 2025). Land-use change may nevertheless increase spillover risk by bringing humans and domestic animals into closer contact with wildlife reservoirs (Plowright et al., 2021; Liao et al., 2026). The Food and Agriculture Organization and the World Health Organization have therefore emphasized ecosystem protection as an important component of pandemic prevention. In some ecological systems, maintaining biodiversity may also reduce pathogen transmission by limiting the abundance or dominance of highly competent reservoir hosts (Hosseini et al., 2017; Ostfeld, 2017).

Nipah virus and Lassa fever provide examples of zoonotic threats associated with changing interactions between humans, livestock, and wildlife. In Malaysia, the expansion of pig farming into areas inhabited by fruit bats contributed to Nipah virus spillover through an intermediate livestock host. In West Africa, environmental disturbance, agricultural expansion, housing conditions, and increased contact with rodent reservoirs may contribute to the transmission of the Lassa virus. These examples illustrate how land-use change can increase spillover risk when combined with agricultural, socioeconomic, and epidemiological factors (Hassan, 2014; Espinosa, Tago, and Treich, 2020; Wegner et al., 2022).

The ongoing global epizootic of highly pathogenic avian influenza A (H5N1) further demonstrates the risks arising at the wildlife–livestock–human interface. The virus has spread across multiple continents, affecting wild birds, poultry, and a growing range of mammalian species, including seals, foxes, and farmed mink. Its unprecedented geographic distribution and repeated transmission between species highlight the vulnerability of intensive poultry and fur-animal production systems, where high animal densities and sustained viral circulation may create opportunities for viral evolution, reassortment, and adaptation to mammalian hosts (Koopmans et al., 2024; Asokan et al., 2026). In 2024 alone, millions of domestic birds were culled worldwide, while human infections were reported in Southeast Asia, South America, and North America, underscoring the continuing threat to animal and public health (Krammer, Hermann, and Rasmussen, 2025).

Other zoonotic viruses also demonstrate how ecological disruption and animal production systems may contribute to disease emergence. Zoonotic coronaviruses, including SARS-CoV and SARS-CoV-2, illustrate how wildlife trade, close contact with wildlife, and habitat encroachment can create conditions conducive to cross-species transmission and, potentially, global spread (Halabowski and Rzymski, 2021). Similarly, swine-origin influenza variants continue to circulate at the human–animal interface, particularly in areas characterized by dense pig production and frequent contact between animals and workers, thereby representing an ongoing source of pandemic risk (Anderson et al., 2021).

Shifting toward a plant-based or flexitarian dietary pattern may contribute to mitigating some of these risks by reducing demand for resource-intensive animal production systems. However, this pathway is indirect and depends on dietary change being translated into actual reductions in the scale or intensity of high-risk production practices. Lower consumption of animal-derived products may reduce pressure for intensive livestock farming and could thereby contribute to fewer opportunities for pathogen amplification and transmission, lower antimicrobial use, and reduced environmental degradation (Rzymski et al., 2021). In particular, intensive animal production has been associated with high antimicrobial use, which contributes to the selection and dissemination of resistant pathogens (Silbergeld et al., 2008; Van Boeckel et al., 2015). One potential pathway through which dietary transitions could reduce zoonotic risk is by lowering economic pressure to expand high-risk animal interfaces (Komati et al., 2025). Intensive livestock farms and open markets that sell live animals are recognized hotspots for pathogen emergence and transmission (Hasan et al., 2025). These settings bring together high densities of animals and humans, often under poor sanitary conditions, which facilitates the spillover of pathogens such as avian influenza viruses and coronaviruses (Bartlett et al., 2022; Jonathon and Gass, 2025; Konishi et al., 2025). Reduced demand for animal products could lessen some of the economic drivers of these systems, provided that it results in corresponding changes in production structures and practices.

Such dietary transitions may therefore form part of a broader One Health prevention strategy by potentially reducing occupational and food-chain exposure associated with high-density animal farming, while also supporting human health, environmental sustainability, and animal welfare (Willett et al., 2019). Nevertheless, dietary change alone cannot prevent zoonotic emergence. Effective risk reduction also requires measures addressing wildlife trade, land-use governance, farm and market biosecurity, integrated surveillance, veterinary and public health capacity, and infrastructure for the early detection and control of emerging pathogens. Thus, transforming food systems toward sustainability could complement these wider preventive measures rather than serving as a stand-alone solution. For these reasons, we advocate for a planned transition toward more plant-based food systems as one element of a broader One Health strategy, supported by policy measures that gradually reduce incentives for high-risk industrial livestock production while increasing support for sustainable, nutritionally adequate, and safe plant-based alternatives.

3.2 Plant-based diets as a One Health strategy to mitigate antimicrobial resistance

From a One Health perspective, AMR represents one of the most pressing global health challenges because it emerges and spreads across interconnected human, animal, and environmental systems. AMR represents a major challenge to public health. In 2021, bacterial AMR was associated with an estimated 4.71 million deaths, of which 1.14 million were directly attributable to resistance (Naghavi et al., 2024). Over the past 30 years, deaths from AMR have decreased among children, yet increased by over 80% among adults 70 years and older. Vaccination, improved sanitation, hygiene, and access to water were highly effective interventions that reduced mortality from AMR in children under 5 years old. In adults, chronic, non-communicable diseases, comorbidities, and age contribute to the development of sepsis, while vaccines are less effective, resulting in higher mortality associated with AMR. It is estimated that by 2050, 1.91 million deaths attributable to AMR and 8.22 million deaths associated with AMR could occur globally (Naghavi et al., 2024).

In agriculture, antibiotics are mainly used for disease prevention and treatment in livestock (Ho et al., 2025). Globally, animal antimicrobial use exceeds human use, accounting for 73% of all antimicrobials in 2017, with projected increases of 67% by 2030. Antibiotic use in food production creates reservoirs of AMR bacteria and genes, which can reach humans directly, via the food chain, or through gut colonization and horizontal gene transfer. AMR genes have also been found in wildlife with no prior exposure to antibiotics (Ho et al., 2025). A recent study estimates global antibiotic use in livestock at around 99,500 tonnes per year, with a confidence range of 68,000–198,000 tonnes (Mulchandani et al., 2023). Intensive livestock production consumes about four times more antibiotics than animals raised outdoors, though usage varies by species (Ritchie and Spooner, 2024).

At the food-system level, a shift toward more plant-based diets may reduce demand for intensive livestock production and could consequently contribute to lower antimicrobial use in food-producing animals. However, this pathway is indirect and depends on dietary changes, producing corresponding changes in the scale, structure, and antimicrobial practices of livestock production. Reduced consumption of animal-derived products, particularly those originating from systems with high antimicrobial use, may therefore complement efforts to limit the selection and dissemination of resistant organisms, but it should not be assumed to directly reduce antimicrobial use without accompanying production and policy changes (Van Boeckel et al., 2015). Moreover, replacing meat with plant-based alternatives may reduce demand for feed crops and concentrated animal production and could thereby limit the environmental dissemination of antimicrobial residues, resistant bacteria, and AMR genes through manure and agricultural runoff (Kelbrick et al., 2023; Shrivas et al., 2025).

A separate question concerns whether dietary patterns are associated with differences in the human gut resistome. Current evidence in this area is limited and largely observational, and therefore does not establish that plant-based diets causally reduce the AMR burden in humans. A large metagenomic study in healthy U.S. adults found that greater dietary diversity and plant-rich diets high in fiber and low in animal protein were associated with a lower abundance of antibiotic resistance genes in the gut (Oliver et al., 2022). Moreover, in an Italian cohort, vegans had a lower total load of selected resistance genes (sul2, tetA, bla, strB) than omnivores, with vegetarians falling in between, suggesting that animal-derived foods may contribute to the accumulation of AMR genes (Losasso et al., 2018). Although these findings suggest that diet may influence the composition of the gut resistome, they cannot demonstrate causation and may be affected by differences in food sources, previous antimicrobial exposure, lifestyle, geography, and other confounding factors. Further longitudinal and intervention studies are needed before dietary change can be regarded as an established strategy for reducing AMR carriage in humans.

Integrating dietary considerations within a One Health framework may contribute to AMR prevention by addressing some of the food-system conditions that support high antimicrobial use and environmental dissemination (Whitman et al., 2025). Nevertheless, dietary transition should be regarded as a complementary measure rather than a substitute for the principal AMR interventions. These include antimicrobial stewardship in human and veterinary medicine, effective regulation of antimicrobial sales and use, prescription-based veterinary oversight, restrictions on routine prophylactic and growth-promoting use, vaccination, infection prevention, improved animal husbandry, biosecurity, disease surveillance, and farm-management practices that reduce the need for antimicrobial treatment. Combined with these measures, a transition toward sustainable, more plant-based food systems could form one component of a broader strategy to limit the emergence and spread of AMR across human, animal, and environmental domains.

3.3 Plant-based diets in One Health approaches to preventing non-communicable diseases

According to the Global Burden of Disease Study 2021, non-communicable diseases accounted for 7.3 trillion global cases, 43.8 million deaths, and 1.73 billion disability-adjusted life years, with the highest burden demonstrated for cardiovascular diseases, cancers, and diabetes (Li et al., 2025a). Although global age-standardized rates of NCDs have declined modestly since 1990, the absolute burden continues to rise, particularly in regions with low sociodemographic index and among men (Li et al., 2025a). Key global risk factors, i.e., high blood pressure, poor diet, tobacco use, and increasing body mass index, reflect systemic drivers that link human health to environmental and food system dynamics (Bennett et al., 2025; Li et al., 2025a). These findings reinforce that addressing NCDs through a One Health framework, traditionally applied to infectious diseases, must extend beyond clinical prevention to tackle shared, upstream determinants, such as unhealthy food environments, pollution, and climate stressors, that compromise both human and planetary health (Winkler et al., 2025). In this context, One Health aims to reduce shared risk factors of NCDs across species and ecosystems by promoting sustainable food systems, decreasing pollution and greenhouse gas emissions linked to chronic disease burden, improving dietary quality and nutritional equity, and fostering resilience to climate-related health threats. Addressing NCDs through One Health, therefore, requires dietary patterns that simultaneously support human metabolic health, animal welfare, and environmental sustainability (Natterson-Horowitz et al., 2022).

A well-planned plant-based diet can provide adequate amounts of most essential nutrients and align closely with national health and dietary guidelines (Craig et al., 2021; Key et al., 2022). Diet rich in vegetables, fruits, wholegrains, legumes, nuts and seeds, along with a variety of minimally processed foods, while being low in added sugars and trans fats, has been shown to support the prevention and management of chronic disease (Rockström et al., 2025), including type 2 diabetes, cardiovascular disease, cancer, and obesity (Kim et al., 2019; Craig et al., 2021; Wang et al., 2023; 2025). In contrast, unhealthy dietary patterns, whether plant-based or with animal-derived products content, characterized by a high intake of sweets, refined grains, ultra-processed foods, and trans fats, together with an inadequate intake of high-quality protein, vegetables, and fruits, are associated with an increased risk of non-communicable diseases and nutritional deficiency (Rockström et al., 2025).

Plant-based diets have a significant impact on metabolic health and reduce risk factors associated with metabolic syndrome. Individuals following a vegan diet tend to have lower central obesity and waist circumference, lower blood pressure, improved lipid metabolism, and better glycemic control (Marrone et al., 2021). A meta-analysis including 2,230,443 participants shows that higher adherence to a plant-based diet is associated with an 18% lower risk of incident Type 2 diabetes (RR = 0.82; 95% CI: 0.77–0.86), a 10% lower risk of cardiovascular disease cases (RR = 0.90; 95% CI: 0.85–0.94), a 12% lower risk of cancer cases (RR = 0.88; 95% CI: 0.84–0.92), and a 16% lower risk of mortality (RR = 0.84; 95% CI: 0.78–0.92) (Wang et al., 2023).

Healthy plant-based diets were associated with a 19% lower risk of cardiovascular disease mortality and an 11% lower risk of all-cause mortality (Kim et al., 2019). Additionally, the high levels of polyphenols in these diets help reduce oxidative stress and inflammation, while leafy green vegetables support endothelial function, reduce the risk of clot formation, and overall cardiovascular health (Jafarnezhad et al., 2025). Vegan and vegetarian diets have been shown to improve lipid profiles (Marrone et al., 2021; Jafarnezhad et al., 2025). Compared with omnivorous diets, consumption of vegetarian or vegan diets was associated with lower levels of total cholesterol, low-density lipoprotein (LDL) cholesterol, and apolipoprotein B (apoB). Plant-based diets are typically higher in polyunsaturated fatty acids and lower in saturated fatty acids, cholesterol, and total fat. Reduced fat intake leads to lower intestinal absorption of triglycerides and cholesterol, and subsequently to decreased levels of cholesterol-containing lipoprotein particles in the blood (Koch et al., 2023). Individuals adhering to a vegan diet demonstrated significant reductions in body weight. A reduction in total and saturated fat intake, accompanied by an increase in fiber intake, lowers dietary energy density and thereby reduces overall energy intake (Tran et al., 2020). Additionally, a low-fat vegan diet increases postprandial energy expenditure. A low-fat vegan diet reduces hepatocellular and intramyocellular lipid concentrations, improves insulin sensitivity, and thereby increases energy expenditure in the postprandial period (Barnard et al., 2022). A plant-based diet may be beneficial for the primary prevention of type 2 diabetes. Healthy plant-based foods, such as fruits, vegetables, whole grains, legumes, and nuts, were associated with a 30% lower risk of type 2 diabetes (Qian et al., 2019). A high-quality plant-based diet provides antioxidants, fiber, micronutrients, and unsaturated fatty acids, which are considered potential protective factors against type 2 diabetes (Qian et al., 2019; Heidarzadeh-Esfahani et al., 2024).

Plant-based eating patterns are also effective for treating individuals with type 2 diabetes (Jardine et al., 2021). Consuming whole, plant-based foods, and avoiding or minimizing animal-derived products, refined foods, and ultra-processed foods could help to achieve remission (Rosenfeld et al., 2022). Such intervention results in a decrease in glycated hemoglobin levels and discontinuation of diabetes-related medications among participants (Toumpanakis et al., 2018). Plant-based diets, when accompanied by educational interventions, can significantly improve psychological health, quality of life, and weight in individuals with diabetes (Toumpanakis et al., 2018). Furthermore, plant-based diets could potentially improve diabetic neuropathic pain by stopping or slowing down the progression of nerve impairment (Bunner et al., 2015; Storz and Küster, 2020). A plant-based diet can help control type 2 diabetes by improving weight loss and reducing fasting blood glucose, total cholesterol, LDL cholesterol, and triglyceride levels (Thompson et al., 2024; Hanick et al., 2025; Schaefer et al., 2025).

Evidence also suggests that plant-based dietary patterns may protect against cancer. A meta-analysis encompassing 1,207,956 participants and 19,328 cases of colorectal cancer demonstrated a significant inverse association between plant-based dietary patterns and colorectal cancer risk (hazard ratio 0.91 [95% CI, 0.85–0.97]) (Xie et al., 2025). This association may reflect not only a higher intake of potentially protective plant-derived compounds but also a lower consumption of red and processed meat, high intakes of which are recognized risk factors for colorectal cancer (Ungvari et al., 2025). Fiber, flavonoids, carotenoids, and phenolic acids possess antioxidant, anti-inflammatory, and hormone-regulating effects that help reduce cancer risk (Nordengen et al., 2025). Furthermore, the protective influence of plant-based nutrition extends to other chronic conditions, as plant-based diets may help prevent and delay the progression of chronic kidney disease (Carrero et al., 2020). A higher intake of plant protein was associated with better adherence to a low-protein diet, a lower dietary acid load, alleviation of metabolic acidosis, and a potential reduction in adiposity. Importantly, these benefits were achieved without compromising lean tissue mass or handgrip strength (Avesani et al., 2024; Hsu et al., 2025).

Despite the abundant evidence supporting the beneficial effects of plant-based diets in the prevention and treatment of noncommunicable diseases, several limitations should be noted. First, much of the available evidence comes from observational studies, not interventional studies. While observational studies can identify associations, interventional studies provide stronger evidence of causal relationships. Second, other lifestyle factors that significantly influence the risk of noncommunicable diseases, such as alcohol consumption, physical activity, and smoking, must also be considered (Toumpanakis et al., 2018). Finally, the definition of a plant-based diet is not standardized and can encompass vegan and vegetarian diets, as well as dietary patterns that occasionally include fish or even meat. Furthermore, the quality of the plant-based diet is an important factor. Diets based primarily on whole, minimally processed plant foods are associated with greater health benefits than plant-based diets high in ultra-processed foods, saturated fats, added sugars, and refined grains (Rockström et al., 2025).

In summary, a well-structured plant-based diet not only supports human metabolic health but also aligns with broader One Health goals by promoting environmental sustainability and reducing animal exploitation. Evidence demonstrates that such diets lower the risk of type 2 diabetes, cardiovascular disease, cancer, obesity, and chronic kidney disease, while improving lipid profiles, glycemic control, body weight, and overall quality of life. Rich in fiber, antioxidants, polyphenols, and unsaturated fatty acids, plant-based dietary patterns also reduce inflammation, oxidative stress, and metabolic risk factors. By mitigating NCDs and their upstream drivers, healthy plant-based diets exemplify an integrative approach that simultaneously benefits human health, ecosystem resilience, and long-term planetary wellbeing.

4 Plant-based diets and animal health

4.1 Plant-based diets and One Health ethical considerations for improving animal welfare

From a One Health perspective, the scale and structure of modern animal agriculture represent a critical intersection between human health, animal welfare, and environmental sustainability. Food systems that rely heavily on intensive livestock production not only shape dietary patterns and nutrition but also influence ecological stability, disease emergence, and the wellbeing of billions of animals. High-density farming systems alter animal–human–environment interfaces, creating conditions that can amplify infectious disease risks, increase antimicrobial use, and intensify environmental pressures on land, water, and biodiversity. Consequently, examining the ethical and welfare implications of animal production is inseparable from broader One Health considerations regarding the sustainability and safety of global food systems. Animal welfare within mainstream livestock production systems can be evaluated using objective, species-specific indicators. In dairy cattle, these include the prevalence of lameness, mastitis, hock lesions, poor body condition, and mortality; in broiler chickens, gait impairment, footpad dermatitis, hock burns, mortality, and thermal stress; in laying hens, feather loss, keel-bone fractures, injurious pecking, and mortality; and in pigs, tail and ear lesions, shoulder sores, lameness, respiratory disease, and stereotypic behaviors (Rioja-Lang et al., 2020). Additional indicators include physiological stress, behavioral restriction, access to enrichment or outdoor areas, thermal comfort, and conditions during transport and slaughter (Nicolaisen et al., 2023). Welfare outcomes should therefore be assessed in relation to the species, production system, management practices, and regulatory environment rather than inferred solely from production scale. These concerns are closely linked to current dietary demand: although several dietary recommendations advise limiting red and processed meat intake to approximately 300–600 g per week, average consumption in Europe remains substantially higher, reaching about 1.2 kg of red meat per week. This sustained demand is reflected in the large scale of European meat production, including annual totals of 6.6 million tonnes of beef and 21.1 million tonnes of pork (Eurostat, 2025).

Animal agriculture operates on a large scale worldwide. Each year, more than 75 billion land animals are slaughtered for meat, and estimates indicate that a substantial proportion are raised in intensive production systems (Ritchie, 2023). In addition, the annual number of farmed fish is estimated to exceed 110 billion individuals (Ritchie, 2023). On average, every single day, an estimated 900,000 cows, 3.8 million pigs, 12 million ducks, 202 million chickens, and hundreds of millions of fish are slaughtered to meet global demand for animal protein (Roser, 2023). In the EU, livestock populations in 2024 included approximately 132 million pigs, 72 million bovine animals, and 67 million sheep and goats, while poultry meat production was estimated at 14.1 million tonnes (Eurostat, 2025). These figures illustrate the population-level significance of even relatively small differences in welfare outcomes between production systems.

Intensive production systems may generate particular welfare risks when high stocking densities, restricted movement, barren housing, genetic selection for rapid productivity, or inadequate environmental control impair animal health or prevent the expression of strongly motivated behaviors (EFSA et al., 2025a). Documented welfare concerns include injury, lameness, heat stress, behavioral restriction, chronic stress, and increased susceptibility to some production-related disorders, although their prevalence and severity vary across species and management systems. These concerns have been reported in fur-bearing animals (Halabowski et al., 2025), laying hens (Expertise For Animals and Stowarzyszenie Otwarte Klatki, 2024), and cattle in confined systems (EFSA et al., 2025b). Intensive systems also involve the routine killing of young animals, e.g., in dairy production, newborn male calves, unsuitable for milk or beef markets, are often slaughtered shortly after birth (Boyle and Mee, 2021), while in the egg industry, male chicks are culled immediately after hatching (Bruijnis et al., 2015). Billions of animals are raised in intensive systems in which welfare impairments may arise from restricted movement, high stocking densities, production-related disorders, and limited opportunities for species-specific behavior (Moen and Devolder, 2022). Economic incentives favoring production efficiency may constrain the adoption of welfare-enhancing practices, particularly when such practices increase production costs (Hernandez et al., 2022). Nevertheless, studies consistently indicate that informed consumers are willing to pay higher prices for products from higher-welfare or free-range systems (Żakowska-Biemans and Tekień, 2017; Rahmani et al., 2019). However, stated willingness does not always translate into purchasing behavior, particularly when higher-welfare products are more expensive, poorly labeled, or less accessible. Consumer demand therefore interacts with policy instruments, retailer standards, public procurement, certification, farm subsidies, and regulatory enforcement in shaping actual welfare outcomes. Technological developments in animal production have also progressed faster in some areas than the adaptation and enforcement of legal welfare standards (Kruk, 2021).

Although extensive grazing, mixed crop–livestock, pastoral, and smallholder production systems differ substantially in terms of animal welfare, environmental impacts, and socioeconomic outcomes, intensive livestock production dominates global animal agriculture, with 74% of land livestock being factory-farmed. Extensive grazing and pastoral systems may allow greater freedom of movement and behavioral expression, but they can also expose animals to climatic extremes, predation, parasites, nutritional shortages, and limited veterinary access. Conversely, well-managed intensive systems may provide reliable nutrition, shelter, environmental control, and disease monitoring, although restrictions on movement, high stocking densities, and limited behavioral opportunities may remain important concerns. Consequently, the large number of animals raised in intensive systems means that welfare challenges associated with these systems have the greatest overall impact on farm animal populations worldwide (Ritchie, 2023). At the same time, welfare outcomes vary within and between production systems depending on species, management practices, housing conditions, stocking density, access to veterinary care, and opportunities for natural behaviors (Paskaš et al., 2026). Transitions to more plant-based dietary patterns should recognize the socioeconomic importance of animal farming for many farmers and rural communities, particularly in regions where farmed animals contribute significantly to subsistence and food security. Well-designed agricultural and rural development policies can facilitate a just transition by supporting farm diversification, the cultivation of protein crops such as legumes, and the development of alternative protein sectors, including cultured meat (Balan and Trasca, 2025; Sandhu et al., 2025). Such actions can also improve the quality of life in rural communities by reducing the environmental burdens associated with intensive livestock production, including odor emissions, air pollution, insect and rodent proliferation, and challenges in waste management (Casey et al., 2015). Supporting farmers through this transition is essential to ensure improved animal welfare, public health, and environmental sustainability without compromising rural livelihoods.

In summary, animal-production systems differ substantially in their welfare impacts and management conditions. Addressing welfare concerns, therefore, requires stronger and consistently enforced regulations, routine monitoring of animal-based welfare indicators, transparent labeling, and greater consumer awareness of production practices. Such measures should be accompanied by socioeconomic support for producers to facilitate the transition towards higher-welfare systems and reduce the aggregate welfare burden associated with animal agriculture (Council of the European Union, 2025).

5 Plant-based diets and environmental impact

5.1 Plant-based diets and One Health pathways for climate mitigation

The climate crisis is one of the most significant global threats, with far-reaching consequences across environmental, social, economic, and health systems (Rocque et al., 2021; Sánchez-García et al., 2025; Zahnow et al., 2025). From a One Health perspective, climate change represents a systemic disruption affecting the interconnected health of humans, animals, and ecosystems. Rising temperatures, altered precipitation patterns, and increasing frequency of extreme weather events influence the distribution of infectious diseases, threaten food and water security, and disrupt ecological stability, thereby amplifying risks across multiple domains of health. Anthropogenic activities, including the burning of fossil fuels, industrial processes, agriculture, and deforestation, have increased the concentration of greenhouse gases (GHG) in the atmosphere (IPCC, 2022). Substantial GHG emission reductions across all sectors are crucial to limiting the increasing frequency of heatwaves, droughts, floods, and wildfires, mitigating sea-level rise, safeguarding food security, and preserving the integrity of ecosystems (UNEP, 2024a). The UNEP Emissions Gap Report 2024 warns that to keep the goal of limiting global warming to 1.5 °C above pre-industrial levels within reach, global greenhouse gas emissions must fall by 42% by 2030 and by 57% by 2035 compared to 2019 levels. Current pledges would put the world on track for around 2.6 °C–2.8 °C of warming, which is far above safe limits (UNEP, 2024c).

Food production is a major contributor to climate change. Globally, agriculture, including livestock and crop production, accounts for roughly 26% of GHG emissions (Ritchie, 2019). Within agriculture, livestock production is particularly emission-intensive due to methane from enteric fermentation, manure management, and the high energy demand of feed production (Li et al., 2025b). Even beyond emissions, the land and resources dedicated to animal agriculture indirectly amplify climate pressures, as deforestation and feed crop cultivation increase carbon release from soils and vegetation (IPCC, 2022). These factors highlight that changes in dietary patterns are a key leverage point for climate mitigation.

Transitioning toward plant-based diets offers a highly effective and practical strategy for reducing climate impacts. Plant-based foods such as grains, legumes, vegetables, fruits, nuts, and seeds require far fewer GHG-intensive inputs than animal-based foods (Bunge et al., 2024). Life-cycle analyses demonstrate that diets low in or free from animal products can reduce GHG emissions by 30%–50% compared with average Western diets and, in some scenarios, up to 70% for diets that fully replace ruminant meat with plant alternatives (Fresán and Sabaté, 2019; Prag and Henriksen, 2020; Scarborough et al., 2023; Bunge et al., 2024; Alcalá-Santiago et al., 2025; Choręziak and Rzymski, 2025). The reductions stem primarily from the elimination of emissions associated with livestock production, which currently accounts for the majority of agricultural methane and a significant share of global nitrous oxide emissions, both potent GHG (Agudelo Higuita et al., 2023).

Beyond direct emissions reductions, plant-based diets contribute to climate mitigation by reducing the demand for energy-intensive livestock production. Livestock requires substantial amounts of feed, water, and land relative to the caloric and protein output it provides (Poore and Nemecek, 2018). Shifting consumption toward plant-based foods decreases the overall energy embedded in food production systems, indirectly lowering fossil fuel use for mechanized farming, fertilizer production, and feed transport (Vermeulen et al., 2012). Currently, livestock accounts for 80% of agricultural land use, and only 16% of crops are directly consumed by humans. Furthermore, vast land use for animal-derived products provides only 17% of the world’s calories and 37% of its protein (Poore and Nemecek, 2018; Ritchie and Roser, 2019). Legumes are more resource-efficient than animal-derived products. Producing 1 kg of protein from kidney beans requires approximately 18 times less land, 10 times less water, 9 times less fuel, 12 times less fertilizer, and 10 times less pesticide than producing 1 kg of beef protein. Additionally, animal waste generated per kilogram of edible protein was approximately 17 kg for eggs, 21 kg for chicken, and 105 kg for beef (Sabaté et al., 2015). Moreover, reducing animal production helps mitigate climate change by decreasing demand for feed, including soy grown for animal feed. Even a 55% shift to a more plant-based diet could reduce soy imports by 50%, facilitating the restoration of drained organic soils and afforestation of surplus agricultural land (Prag and Henriksen, 2020).

Global modeling studies further illustrate the transformative potential of dietary shifts. If 50% of the main animal-derived foods (beef, chicken, pork, and milk) are substituted globally by alternative plant-based protein sources by 2050, GHG emissions decrease by 31%, agricultural area by 12%, and water use by 10% compared to 2020 (Kozicka et al., 2023). These reductions are highly relevant to achieving international climate targets, as dietary shifts alone could account for a meaningful portion of the emissions reductions required to keep warming below 1.5 °C. Importantly, plant-based diets are also highly scalable, as crop-based foods are widely available and can be adapted to diverse cultural and geographic contexts (Clark et al., 2020). However, replacing animal products with highly processed plant-based alternatives, imported foods, or crops linked to land-use change, including soy and oilseeds produced in regions affected by deforestation, may reduce the expected environmental and health benefits. Therefore, the benefits of plant-based diets can be maximized by choosing minimally processed plant foods, supporting sustainable agricultural practices, and, where appropriate, sourcing foods from local or regional producers (Rockström et al., 2025).

From a One Health perspective, plant-based diets can be viewed as an important climate-mitigation strategy with interconnected benefits for human, animal, and ecosystem health. By reducing greenhouse gas emissions and energy use associated with food production, dietary shifts towards plant-based foods may help limit global warming and the associated risks of heatwaves, extreme weather, climate-sensitive diseases, and food insecurity (Whitman et al., 2025). Promoting such dietary transitions should therefore be recognized as a scalable, evidence-based component of climate action and resilient food systems.

5.2 Plant-based diets and One Health solutions to deforestation and land degradation

From a One Health perspective, forests are essential components of planetary health systems because they sustain the interconnected wellbeing of humans, animals, and ecosystems. Forests play a crucial role in protecting the climate system, providing clean air, purifying water and soil, and regulating water cycles by retaining and recharging groundwater, thereby helping prevent desertification. Healthy forest ecosystems also support biodiversity and act as natural buffers that limit the spread of infectious diseases by maintaining ecological balance among wildlife hosts and vectors. Conversely, deforestation and forest degradation weaken these protective functions, reduce essential carbon sinks, and increase the likelihood of contact among wild animals, farmed animals, and humans, thereby elevating the risk of emerging infectious diseases and epidemics (European Parliament, 2023). Over the past 3 decades, approximately 10% of the world’s forests, an area larger than the European Union, have been lost globally due to deforestation (European Parliament, 2023). For the period 2010–2014, net emissions of 2.6 gigatonnes of carbon dioxide were due to deforestation associated with the expansion of croplands, pastures, and forestry plantations in the tropics, making deforestation the second-largest source of anthropogenic GHG (Pendrill et al., 2019).

The largest areas of forest loss are in the tropics, which harbor the highest levels of biodiversity (Ritchie, 2021a). From 2002 to 2024, 83 Mha of humid primary forest were lost globally, accounting for 16% of total tree cover loss. The total area of humid primary forest decreased globally by 8% in this time period. Between 2015 and 2020, we lost 7.5 Mha of forest due to deforestation, with the highest rates in Brazil (1.7 Mha/year), India (670 kha/year), Indonesia (650 kha/year), and the United Republic of Tanzania (470 kha/year) (Global Forest Watch, 2026). The consequences of deforestation in the tropics are severe, including reduced rainfall, increased local and global temperatures (Smith et al., 2023), degradation of soil functions (Veldkamp et al., 2020), and decreases in the numbers of pollinators (Boyle et al., 2025), birds, amphibians, and mammals (Betts et al., 2017).

Globally, between 2001 and 2024, approximately 33% of tree cover loss occurred in areas where deforestation was driven by permanent agricultural expansion (Global Forest Watch, 2026). Deforestation in the Amazon is directly linked to the expansion of cattle ranching, where land use shifts from native forests to pasture for beef cattle production (Donoso et al., 2024). The expansion of pastureland to raise cattle between 2010 and 2014 accounted for 41% of tropical deforestation, or 2.11 million ha annually (Ritchie, 2021b). Beef production in Brazil has nearly doubled over the past 25 years, from 5.79 million tonnes in 1998 to 11.16 million tonnes in 2023 (Ritchie et al., 2019).

Rainforest deforestation also increased due to the production of animal feed, especially soy. Soy is now one of the most widely grown crops in the world, a valuable source of protein in plant-based diets, a raw material for oil production, and an animal feed ingredient. Yet, only 6% of global soy production is used for direct human food. More than 75% is produced for animal feed, mostly for chicken and pigs (Fraanje et al., 2020). Therefore, the environmental impacts associated with soy expansion are driven primarily by the demand for livestock feed rather than by the direct consumption of soy-based foods. Soybean yields have multiplied about 3 times since the early 1960s. The amount of land used to grow soy in South America increased by more than 200 times from 0.26 Mha in 1961 to 68,68 Mha in 2024 at the expense of loss of native vegetation and deforestation (Fraanje et al., 2020; FAOSTAT, 2026).

Switching toward more plant-based dietary patterns can substantially reduce deforestation pressure by lowering demand for grazing land and feed-crop production. This is particularly relevant because cattle ranching and the cultivation of feed crops, including soy, are major contributors to agricultural expansion into forested and biodiverse regions. By reducing the land requirements of food production, plant-based dietary transitions may create opportunities for forest restoration, rewilding, afforestation, agroforestry, and the development or maintenance of extensive biodiverse green spaces. Increasing or maintaining forest cover improves carbon sequestration, supports climate change mitigation, enhances hydrological regulation, reduces surface runoff and erosion, stabilizes soils, and helps maintain biodiversity and ecosystem services (Nabuurs et al., 2007). Reducing livestock production may also decrease methane and nitrous oxide emissions while enabling biomass recovery on land currently used for raising animals or producing feed (Eisen and Brown, 2022).

However, dietary change alone should not be interpreted as sufficient to preserve forests or prevent environmental damage from logging, agricultural expansion, or unsustainable land management. The forest-related benefits of plant-based dietary transitions depend on what foods replace animal products, how these foods are produced and sourced, and whether spared land is actively protected, restored, or converted into resilient green infrastructure. Increased demand for some plant commodities, such as vegetable oils or deforestation-linked imported crops, may still contribute to land-use change if production expands into forests or other carbon-rich ecosystems (Kesse-Guyot et al., 2023; Chiriacò et al., 2025). Therefore, plant-based diets should be understood as one important demand-side strategy within a broader One Health approach that also requires forest governance, anti-deforestation supply chains, sustainable agriculture, restoration of degraded land, and protection of biodiverse green spaces. In this more nuanced sense, reducing meat consumption aligns closely with the core principles of One Health: it can reduce pressure on forests and land resources while supporting climate mitigation, biodiversity conservation, food security, and long-term planetary health.

5.3 Plant-based diets and One Health approaches to conserving water resources

From a One Health perspective, freshwater resources are fundamental to the interconnected health of humans, animals, and ecosystems. Water availability and quality influence food production, disease transmission, ecosystem stability, and overall public health outcomes. World water resources are estimated at about 1,400 million km³, of which freshwater accounts for only about 35 million km³ (2.5%). Nearly two-thirds of this freshwater is contained in ice and glaciers, making it largely inaccessible for human use. Renewable and more readily accessible freshwater resources come primarily from precipitation over land, lakes, rivers, and shallow groundwater systems (FAO, 2026). Moreover, access to freshwater resources is unevenly distributed geographically; for example, water deficits are particularly severe in regions such as the Middle East, Sub-Saharan Africa, and southwestern China (Hajat et al., 2023; Zhu et al., 2024).

Freshwater scarcity is further intensified by climate change, land-use change, and rising demand from food systems. Drought-driven water scarcity events, arising from compound hydrological extremes including prolonged rainfall deficits, reduced river flows, and increased water consumption, have already been observed in the 2020s and are projected to recur or intensify in the 2030s. Projected hotspots include the Mediterranean Region, southern Africa, northern South America, the western part of North America, Australia, and Latin America, including areas dependent on major reservoirs (Rodríguez et al., 2022; Baba et al., 2025; Ravinandrasana and Franzke, 2025). As a consequence of global warming, droughts and floods are expected to become more frequent, potentially reducing the reliability of freshwater supplies. Reduced water availability limits irrigation, lowers agricultural productivity, and directly threatens food production and food safety.

Agriculture accounts for approximately 70% of freshwater withdrawals and remains the dominant global user of freshwater resources, with crops grown for livestock feed accounting for about 41% of total agricultural water use (Heinke et al., 2020). Projected population growth, rising incomes, and shifts toward more resource-intensive diets are projected to further intensify water demand. By 2090, climate change and land-use alterations could increase the global water footprint by up to 22% (Mekonnen and Gerbens-Leenes, 2020). Reduced water availability limits irrigation, lowers agricultural productivity, and directly threatens food production and food safety. At the same time, the world’s consumption of meat is rising and intensifying, especially in rapidly developing economies. Intensive livestock production systems are highly inefficient in terms of water and feed resources, as large quantities of crops and freshwater are required to produce relatively small amounts of animal-derived products compared with direct consumption of crops (Turral et al., 2011).

Global water consumption related to crop production is estimated at 5,938–8,508 km³ per year (Mekonnen and Gerbens-Leenes, 2020). The food system uses blue water, i.e., surface and ground water used for irrigating plants and watering livestock, green water, i.e., rainwater collected in the soil, and grey water, i.e., the volume of water required to dilute pollutants. Annually, 4,387 km³ of blue and green water is used for the production of crops for livestock feed, equaling about 41% of total agricultural water use (Heinke et al., 2020). Animal-based food production also requires water beyond crop irrigation, including water for animal drinking, hygiene, slaughter, processing, and pollution management. Livestock production needs extra water for purification and ecosystem buffering. Significant amounts of water from animal production are used to manage and dilute pollutants from animal slaughter, manure runoff, and synthetic fertilizers used on feed crops (FAO, 2019). Reducing meat consumption can indirectly improve water quality and reduce exposure to waterborne pathogens, though the magnitude of this effect depends on local sanitation, water management, and agricultural practices. Water requirements also vary depending on the type of production system. Industrial, intensive animal production systems require large amounts of concentrated feed, the production of which contributes substantially to the overall water footprint of livestock systems (Mekonnen and Hoekstra, 2012).

Together, these factors make the water footprint of animal-derived products greater than that of plant-based products with equivalent nutritional value. For example, the average amount of water needed to produce 1 kg of beef is 15,400 L, and for 1 kg of lentils, 1,250 L (Mekonnen and Hoekstra, 2012). When expressed per unit of protein, the water footprint of eggs (3,863 L per kg) and chicken (4,300 L per kg) is 1.5 times greater than that of legumes. The average water footprint per calorie of beef is about 20 times higher than that of cereals and starchy roots, and, per unit of protein, the water footprint of beef is about 6 times higher than that of legumes (Mekonnen and Gerbens-Leenes, 2020). Plant-based diets tend to have lower green water footprints than current average diets, while omnivorous diets generally exhibit the highest overall water footprint (Harris et al., 2020; Polyak et al., 2023).

Beyond water quantity, livestock production and intensive agriculture also affect water quality, which is central to the One Health framework. Human activity, particularly intensive agriculture, leads to excess nutrients such as nitrogen and phosphorus in surface waters, which promotes eutrophication and harmful algal blooms. The subsequent decomposition of these organisms decreases dissolved oxygen levels in the water, which can lead to the formation of dead zones and biodiversity loss. Furthermore, cyanobacteria produce toxins that are hazardous to humans and animals, making polluted water unsuitable for drinking, recreation, and supporting aquatic organisms (Akinnawo, 2023; Falfushynska et al., 2023; Thawabteh et al., 2023).

More than half of the world’s population is affected by freshwater scarcity at least temporarily, increasing the risk of infectious disease outbreaks. Water shortages intensify human exposure to contaminated water sources, and extensive animal agriculture increases contamination and human contact with animal feces through water, food, and direct contact. Fecal pathogens pose a particularly serious risk, including Campylobacter, nontyphoidal Salmonella, Lassa virus, Cryptosporidium, and Toxoplasma gondii. These five pathogens cause nearly one million deaths annually (Delahoy et al., 2018). The use of contaminated water for crop irrigation can further facilitate the transmission of infectious diseases, especially where hygiene conditions are inadequate, thereby exacerbating poverty, food insecurity, and malnutrition (Ravinandrasana and Franzke, 2025). Between 2010 and 2018, 263 conflicts over access to water were recorded, resulting in injuries and even deaths (WWAP, 2019). Therefore, protecting water resources is essential not only for food production but also for reducing infectious disease risks, preventing social conflict, and safeguarding aquatic ecosystems.

Plant-based diets can influence water consumption and pollution through two main pathways. First, they reduce demand for livestock production, which requires large volumes of water for animal use, hygiene, slaughter, and processing, and indirectly for the cultivation of feed crops. Second, by lowering demand for feed production and manure-generating livestock systems, plant-based dietary shifts can reduce nutrient runoff, manure contamination, fertilizer use, eutrophication, and the release of fecal pathogens into aquatic environments (Poore and Nemecek, 2018). Therefore, the water-related benefits of plant-based diets are not limited to lower water footprints per unit of food or protein, but also include reduced pressure on water quality and aquatic ecosystem health. In regions affected by freshwater scarcity or inefficient water governance, these demand-side reductions may be particularly relevant, as they can reduce pressure on already limited water resources, though they must be combined with rational water management, efficient irrigation, pollution control, and protection of freshwater ecosystems. Thus, switching toward more plant-based dietary patterns is not only a nutritional choice but also a demand-side strategy for protecting global water resources, reducing water pollution, lowering disease risk, and safeguarding aquatic ecosystems within the One Health framework. These benefits arise mainly from reduced reliance on water-intensive livestock production, lower demand for feed crops, decreased manure and slaughter-related waste, and reduced nutrient runoff contributing to eutrophication. However, as with deforestation, these outcomes depend on sustainable agricultural practices, responsible sourcing, efficient irrigation, and policies that protect freshwater ecosystems. Plant-based diets can therefore support SDG 6 (Clean Water and Sanitation), SDG 2 (Zero Hunger), and SDG 13 (Climate Action) (UNEP, 2024b), but they should be viewed as part of a broader water-management and sustainable food-system strategy rather than as a stand-alone solution.

5.4 Plant-based diets and One Health strategies for protecting biodiversity

From a One Health perspective, biodiversity is a fundamental determinant of the interconnected health of humans, animals, and ecosystems. Diverse and functioning ecosystems regulate disease dynamics, sustain food production, and maintain environmental conditions necessary for human wellbeing. Therefore, protecting biodiversity is of critical significance, as more than 75% of the world’s food crops rely on pollinators, over 50% of modern medicines come from natural sources, forests store approximately 80% of terrestrial biodiversity and absorb 2.6 billion tonnes of carbon dioxide annually, while healthy ecosystems provide 75% of global freshwater resources (WHO, 2025). Within food systems, the principal biodiversity pressures arise from the conversion of natural habitats, the scale and location of agricultural land use, production intensity, and the use of fertilizers, pesticides, and other chemical inputs.

Land use change, such as the conversion of natural habitats to agricultural land, has been a major driver of global biodiversity loss. Nearly 80% of the global impacts of land use change were associated with increased agrifood exports from Latin America, Africa, and South Asia. Outsourcing agrifood production to the tropics has resulted in a global species loss of 1.4% since 1995, indicating a cumulative extinction rate around 50 times higher than the planet’s safe limit (Cabernard et al., 2024). Developed countries contribute significantly to international biodiversity loss by driving land-use changes in other countries through the consumption of imported agricultural products, such as beef, animal feed, and plant-based commodities. Over 13% of the total range loss of obligate forest species between 2001 and 2015 has been attributed to just 24 developed countries (with the United States of America, Japan, China, Germany, and France on top of the list), resulting in habitat loss beyond their borders. Consequently, this leads to significant biodiversity losses in tropical regions (Wiebe and Wilcove, 2025).

Tropical forests harbor 62% of the world’s terrestrial vertebrate species, yet cover only 18% of the total global land area, which is more than twice the number found in any other terrestrial biome. Up to 29% of global vertebrate species are endemic to tropical forests, and more than 20% of these are threatened with extinction (Pillay et al., 2022). Biodiversity is threatened by climate change, pollution, overexploitation of natural resources, and habitat loss. These pressures are largely driven by human agricultural activities, such as deforestation for pastures, the expansion of monocultures, and land reclamation for fodder cultivation. As a consequence, habitat fragmentation and isolation occur, along with changes in food webs, reduced resource availability, and decline in key species (Ryser et al., 2019).

Two related but distinct agricultural pathways should be recognized. First, animal agriculture affects biodiversity through pasture expansion and the cultivation of feed crops, particularly where these activities replace natural ecosystems or promote large-scale monocultures. Second, the expansion of crops intended for direct human consumption or industrial uses can also cause substantial biodiversity loss when it involves deforestation, habitat conversion, intensive monoculture, excessive irrigation, or heavy pesticide and fertilizer use. Thus, biodiversity impacts depend not only on whether a product is animal- or plant-derived, but also on where and how it is produced.

Biodiversity loss weakens interspecies relationships and negatively impacts ecosystems, resulting in the loss of insects, birds, bats, and other animals that function as pollinators (Liu et al., 2018). Extensive monocultures are associated with reduced pollinator availability and reduced pollination levels. Of particular concern is the rapid expansion of oil crops, primarily soybeans, a substantial proportion of which is used for animal feed, which has contributed to declining agricultural diversity in several countries in the Americas and Asia. These regions are experiencing increasing dependence on pollinators for agricultural production, while agricultural practices that harm pollinator populations are becoming more widespread (Aizen et al., 2019). In addition, land drainage and reclamation, long-term cultivation of single crops, and the disappearance of mid-field habitats reduce soil biodiversity and weaken the capacity of agricultural systems to regenerate. The loss of host specificity among many soil bacteria and fungi, as well as larger soil fauna, facilitates the spread and expression of soil-borne diseases (FAO, ITPS, GSBI, SCBD and EC, 2020). Widely used veterinary drugs and pesticides, heavy metal and metalloid contamination, and pathogen infections from animal excreta also contribute to biodiversity loss (Nuruzzaman et al., 2025).

Intensive agricultural practices contribute to soil acidification and eutrophication of surface waters, including lakes and rivers. Excessive and inappropriate fertilizer use leads to a decrease in soil pH, which results in a decline in organisms crucial to soil structure, alters nutrient availability, eliminates sensitive plant species, and releases toxic aluminum ions, thereby reducing biodiversity. Moreover, excess fertilizers used in agriculture can run off into nearby surface waters. Lakes and rivers enriched with nutrients, primarily nitrogen and phosphorus, experience excessive algal growth, whose blooms and decay reduce dissolved oxygen levels and cause fish mortality (Nuruzzaman et al., 2025). Food production causes 32% of global terrestrial acidification and 78% of global eutrophication, with the farm stage dominating, accounting for 61% of food’s GHG emissions (81% when including deforestation), 79% of acidification, and 95% of eutrophication. Research indicates relatively strong correlations between acidification and eutrophication impacts for pork, poultry meat, and milk, largely driven by manure management and associated nitrogen and phosphorus emissions (Poore and Nemecek, 2018). Marine ecosystems are also rapidly losing populations and species, including those in estuaries, coral reefs, and coastal and oceanic fish, due to eutrophication and acidification (Liu et al., 2018). Increasing levels of nutrient-related pressure indicators, such as ammonium, nitrate, and phosphate, lead to declines in sensitive species, shifts in species composition, and disruptions of food webs and trophic interactions. As a long-term consequence, eutrophication causes algal blooms and oxygen depletion, leading to so-called “dead zones” (Wang, 2024).

Reducing the area of land for cultivation, particularly for livestock feed, and adopting sustainable agricultural practices may create opportunities for ecosystem restoration, carbon sequestration, improved water retention, and biodiversity recovery (IPCC, 2022; Ghimirey et al., 2025). Many plant-based foods require less land and generate lower environmental impacts than animal-derived products, particularly those originating from intensive livestock systems. Nevertheless, plant-based production is not inherently biodiversity-friendly, and its impacts vary according to crop type, geographical location, irrigation requirements, chemical inputs, landscape structure, and whether production causes direct or indirect land-use change (Gibbs and Cappuccio, 2022). Reducing meat and dairy production and consumption also decreases methane emissions from enteric fermentation, nitrous oxide emissions from manure, and CO₂ emissions, while freeing land for carbon sequestration (Carey et al., 2023). Research indicates that shifting to balanced dietary patterns could result in large reductions in greenhouse gas emissions (54%–87% across scenarios), moderate reductions in nitrogen application (23%–25%) and phosphorus application (18%–21%), and small to moderate reductions in cropland use (8%–11%) and freshwater consumption (2%–11%) (Springmann et al., 2018).

Overall, plant-forward dietary transitions may support biodiversity by reducing aggregate demand for pasture and animal-feed production, but these benefits are conditional rather than automatic. They are most likely to occur when dietary change is combined with sustainable farming practices, diversified crop rotations and agroecological systems, reduced pesticide and fertilizer inputs, protection of semi-natural habitats, deforestation-free supply chains, and strong governance preventing agricultural expansion into biodiversity-rich areas. Without these safeguards, the expansion of plant-based commodity production may shift rather than eliminate biodiversity pressures.

From a One Health perspective, reducing the most environmentally damaging forms of industrial animal production, together with improving agricultural practices across both animal and plant production systems, could contribute to less habitat destruction, lower pollution, and more resilient ecosystems (Winkler et al., 2025). Faced with the rapid decline of biodiversity, which threatens the survival of approximately a million species and impacts the lives of billions of people, the Kunming-Montreal Global Biodiversity Framework aims to halt and reverse the loss of natural resources. Among the twenty-three goals to be achieved by 2030 are protecting at least 30% of land, sea, and inland waters, and restoring at least 30% of degraded ecosystems (UNEP, 2022). These commitments are closely aligned with the Sustainable Development Goals, particularly those related to the protection of life on land (SDG 15), life below water (SDG 14), and the sustainable use of natural resources, including responsible consumption and production (SDG 12) (UNEP, 2024b).

6 Challenges

Despite the well-documented health, environmental, and ethical benefits of plant-based dietary patterns, their widespread adoption faces several practical challenges. These barriers arise from cultural traditions and established dietary habits, economic and market constraints, agricultural and production limitations, potential nutritional concerns when diets are poorly planned, and policy and governance factors. Understanding these interconnected challenges is essential for designing effective strategies that support gradual, culturally appropriate shifts toward more plant-forward and sustainable food systems, rather than requiring complete adoption of plant-based diets. Table 1 summarizes the main categories of challenges associated with plant-based diets and potential strategies to address them, while the subsequent subsections discuss them in detail.

6.1 Dietary habits and traditions

The food people choose daily - prefer, like, or avoid - is shaped by culture, geography, social factors, and health considerations. The traditions, experiences, and religious practices of people from different countries and continents are distinctive to each nation, reflecting their culinary heritage and identity through unique ingredients they use and diverse preparation (Jayasinghe et al., 2025). Food is a central component of daily life, yet many dietary patterns are neither healthy, ethical, nor environmentally sustainable. When the Mediterranean and Okinawa diets are often considered as healthy and environmentally sustainable, other dietary patterns may require particular attention, such as the Western diet. High consumption of animal products (particularly fatty meat, red and highly processed meat, dairy products, and sweets) combined with low intake of vegetables, fruits, legumes, and whole grains is associated with an increased risk of non-communicable diseases and places substantial pressure on natural resources (Clemente-Suárez et al., 2023).

Dietary habits and traditions are also shaped through socialization. Family meals promote healthy eating and wellbeing among parents, children, and adolescents (Oliveira et al., 2024). Plant-based meals, or meals in which plant foods are more prominently incorporated into familiar family dishes, prepared at home from an early age, promote healthy eating habits and meal-planning skills, supporting physical and mental health, while also reducing environmental impact. At the same time, diverse plant foods and plant-forward versions of culturally familiar meals help children gradually adapt to their taste and texture. Early adaptation to a plant-based diet may support better control of food intake through homeostatic mechanisms, promoting balanced, healthy meals. At the same time, repeated exposure to diverse plant foods and plant-forward versions of culturally familiar meals during childhood may shape hedonic responses by influencing taste preferences and food acceptance (Bligh et al., 2015; Klementova et al., 2019; Havermans et al., 2021; Zuñiga-Martínez et al., 2024; Wiśniewska et al., 2025). The EAT-Lancet Commission emphasizes that increasing demand for healthy and sustainable diets requires system-level interventions, including improvements in the food environment, next-generation culinary research and development, increased purchasing power, and the protection and promotion of healthy traditional diets (Rockström et al., 2025).

6.2 Economics and market barriers

Affordability and price are barriers to accessing safe and nutritious food. More than three billion people worldwide cannot afford a healthy diet (Masters et al., 2025). Regions where grains and starches are staples result in deficiencies in protein, essential fats, and micronutrients. Market barriers also contribute to the availability of affordable and healthy food, including limited access to diverse plant-based products, the high cost of alternatives, and inefficient supply chains in low-resource settings (Jetter and Cassady, 2006; Evans et al., 2015; Canales, 2021; Shepperdley et al., 2024). The average global cost of meeting all essential nutritional requirements using the cheapest foods is 2.33 USD per day, which is significantly more than the international poverty threshold of 1.90 USD. The cost of a healthy diet exceeds current food expenditure for more than 57% of the population in sub-Saharan Africa and South Asia, as well as for a substantial proportion of people in Latin America. Education and individual behavioral change are not sufficient to achieve these dietary goals, as even the least expensive foodstuffs from the required food groups are beyond the reach of low-income people (Herforth et al., 2020).

At the same time, a significant proportion of food produced globally is lost or wasted. This results in the inefficient use of resources required for food production and distribution, contributing to climate change, biodiversity loss, and economic losses. The increased availability of food, rapid economic development, and rising prosperity, particularly in developing countries, have contributed to growing challenges related to food waste and overconsumption. Reducing food waste while promoting healthy, balanced, and environmentally sustainable diets is therefore essential for improving food system efficiency (Huang et al., 2020; Kenny and Sage, 2021).

A modeling study of comparative food prices from the International Comparison Program for 150 countries found that, compared with the costs of traditional diets, plant-based diets based on legumes and whole grains were on average 22%–34% less expensive in upper-middle- and high-income countries, but 18%–29% more expensive in lower-income regions. However, healthy and sustainable dietary patterns, combined with food waste reduction, socioeconomic development, climate change mitigation, and lower healthcare costs, were on average 25%–29% less expensive overall in low-income countries. Vegetarian and vegan diets based on legumes and whole grains were the most affordable, whereas pescatarian diets were among the least affordable (Springmann et al., 2021). This funding is consistent with the analysis of the EAT-Lancet reference diet, which found that fruits and vegetables and animal-source foods are the most expensive components of the diet (Hirvonen et al., 2020).

Transforming food systems toward more plant-forward dietary patterns, including modest reductions in animal-source food consumption where appropriate, could lead to systems that are less resource-intensive and environmentally burdensome. However, such a transformation would require structural adjustments, with some sectors shrinking (e.g., livestock production) and others expanding (e.g., fruit, vegetable, and nut production) (Rockström et al., 2025). The global transition toward healthy plant-based diets is estimated to cost approximately 0.2%–0.4% of global GDP annually, but could generate economic benefits of up to 10 trillion USD per year through improvements in health outcomes, climate mitigation, and environmental protection (Ruggeri Laderchi et al., 2024).

6.3 Agricultural and production limitations

Climate change is impacting food security through rising temperatures, changing rainfall patterns, and increased extreme events. Yields of some crops, such as maize and wheat, in many lower-latitude regions have declined due to observed climate change, while some higher-latitude regions have experienced yield increases. Warming, exacerbated by drought, has significantly reduced crop yields in some parts of the Mediterranean, but the impact is particularly severe in drylands, including Africa and the high-altitude regions of Asia and South America (IPCC, no date). These differences result in unequal access to nutritious food worldwide. For example, the average daily protein supply worldwide is not evenly distributed. In 2023, China had a per capita protein supply of 131 g per day, the United States had 123 g, whereas in Central and Southern Africa, the average was approximately half that level, with Botswana at 73 g per capita and the Democratic Republic of Congo only 28 g per capita (Our World in Data, 2026). Supporting crop development and producing safe, nutritious food are crucial to ensuring equal access and are a key component of UN Sustainable Development Goal 2 (Zero Hunger) by 2030. This requires strengthening sustainable, resilient food systems, improving access to nutrient-rich foods, boosting small-scale farmers’ incomes, and enhancing food safety standards.

In this context, legumes are particularly important as a food group for human populations worldwide. They are inexpensive, widely available, and easy to store, and contain approximately 20–40 g. In addition, legumes have low greenhouse gas and water footprints, increase soil fertility through biological nitrogen fixation, and represent a sustainable source of dietary protein. Despite these advantages, global consumption of legumes remains relatively low (Semba et al., 2021).

Although much of the land used for grazing is not suitable for arable crop production because of differences in soil quality, moisture, topography, and climate, plant-forward diets generally require less agricultural land overall. A global shift towards such diets, even without completely eliminating animal-derived products, could reduce the land required for livestock grazing and feed production, thereby limiting further deforestation and agricultural expansion. Estimates suggest that global agricultural land use could decrease by approximately 75%, largely because of reduced grazing areas and lower demand for feed crops (Poore and Nemecek, 2018). Some land released from livestock production could subsequently be restored or rewilded, supporting biodiversity recovery and carbon sequestration, although its potential future use would depend on local ecological and socioeconomic conditions (Ritchie, 2021c).

6.4 Nutritional challenges and prevention of deficiencies

A plant-based diet can meet nutritional requirements across the life course; however, appropriate nutritional education and dietary planning remain important (Raj et al., 2025). The risk of inadequate intake of vitamin B12, vitamin D, calcium, iron, zinc, iodine, omega-3 fatty acids, and protein is most relevant to fully plant-based vegan diets. Such deficiencies are generally less likely in plant-forward or flexitarian diets that retain some animal-derived foods, although nutritional adequacy still depends on overall dietary quality. In vegan diets, diverse food choices, fortified foods, and supplementation, where necessary, can help ensure adequate nutrient intake and support optimal health (Craig et al., 2021). Nutrients requiring particular attention include vitamin B12, vitamin D, calcium, iron, zinc, iodine, omega-3 fatty acids, and protein.

Vitamin B12 is of particular importance because unfortified plant foods do not provide a reliable source of this vitamin. Deficiency may cause hematological and neurological complications, while substantial hepatic stores can delay the appearance of symptoms (Langan and Goodbred, 2017; Fernandes et al., 2024). Individuals following vegan diets should therefore obtain vitamin B12 consistently from fortified foods or supplements (Lederer et al., 2019). Vitamin D intake may also be inadequate, although limited sunlight exposure, higher latitude, age, body weight, and lifestyle are important risk factors irrespective of dietary pattern. Fortified foods or supplementation may therefore be required according to individual circumstances and national recommendations (Jager et al., 2018; Cui et al., 2023; Gibbs and Cappuccio, 2024).

Calcium intake may be insufficient when vegan diets do not regularly include fortified plant-based beverages, calcium-set tofu, legumes, nuts, seeds, or suitable vegetables. This may be particularly important for children, older adults, and others with increased requirements or a higher risk of impaired bone health (Key et al., 2022; Bickelmann et al., 2023). Iron and zinc are widely available in plant foods, but their bioavailability may be reduced by phytates and other dietary compounds. Adequate intake can be supported through dietary variety and food-processing techniques such as soaking, sprouting, fermentation, and cooking. Consuming vitamin C-rich foods with meals can additionally enhance non-hem iron absorption (Lowe et al., 2024; López-Moreno et al., 2025; Majumdar et al., 2025). Iodine also requires attention because its concentration in plant foods is variable and depends partly on soil and agricultural conditions. Reliable sources may therefore be limited in vegan diets, particularly when iodized salt and fortified foods are not consumed. Supplementation may be necessary where dietary intake remains inadequate, although excessive iodine intake should also be avoided (Craig et al., 2021; Hatch-McChesney and Lieberman, 2022; Pehrsson et al., 2022).

Protein adequacy is generally achievable when energy intake is sufficient and the diet includes a variety of legumes, grains, nuts, seeds, and soy products. Although individual plant foods differ in amino acid composition and digestibility, complementary proteins do not need to be combined within the same meal. Consuming diverse protein sources throughout the day is sufficient to support essential amino acid intake in most individuals (Mariotti and Gardner, 2019; Hertzler et al., 2020; Rychlik et al., 2024; Sharma et al., 2025).

Thus, the nutritional challenge associated with plant-based dietary transitions lies primarily in their appropriate implementation rather than in an inherent inability of plant foods to support health. Within a One Health strategy, recommendations to increase plant-food consumption should therefore be accompanied by accessible dietary guidance, appropriate fortification and supplementation policies, consideration of vulnerable population groups, and monitoring of nutritional status where indicated. This is particularly important when promoting fully vegan diets, whereas gradual plant-forward or flexitarian transitions generally require fewer nutritional adjustments.

6.5 Policy and governance challenges

Agricultural subsidies are an important policy instrument shaping food production, market prices, and dietary patterns (Springmann and Freund, 2022). Depending on their design, they can either support the transition towards healthier and more sustainable food systems or reinforce environmentally intensive forms of production. In many high-income countries, substantial public support is directed towards animal agriculture through direct livestock payments, support for dairy production, and subsidies for crops used as animal feed. By reducing production costs and financial risks, these measures may contribute to lower market prices and sustained consumption of animal-sourced foods, while failing to account fully for associated environmental and public-health costs (Rust et al., 2020). The European Union’s Common Agricultural Policy (CAP) provides a prominent example. Decisions regarding the CAP for 2028–2034 offer an opportunity to align agricultural support more closely with food security, public health, and environmental objectives. However, an estimated 77% of CAP subsidies in 2020 supported animal-sourced foods, including support allocated to crops used as animal feed, amounting to more than three times the support provided to plant-based foods (Foodrise, 2026). Reforming such support to facilitate the production of legumes, fruit, vegetables, and other foods intended directly for human consumption could promote more sustainable diets while providing financial and technical assistance to producers during the transition.

National dietary guidelines and climate strategies also have an important role in supporting healthier and more sustainable dietary patterns. However, an analysis of national dietary guidelines revealed substantial gaps in recommendations concerning well-planned vegetarian diets and appropriate substitutions for animal-source foods (Klapp et al., 2022). Dietary changes aligned with national recommendations may reduce premature mortality from diet-related non-communicable diseases, but greater benefits may be achieved through clearer recommendations to increase plant-food consumption and moderate the intake of animal-source foods. Moreover, many national dietary guidelines remain inconsistent with global environmental objectives related to climate change and resource use (Springmann et al., 2020). Integrating dietary guidance into national climate and food strategies, supporting sustainable food production, and raising public awareness of the environmental impacts of food choices may help translate recommendations into population-level change (Berti et al., 2025).

The effectiveness and acceptability of such policies depend on how they are implemented. Measures should improve access to affordable and nutritious foods, recognize cultural and regional dietary practices, and support feasible changes rather than prescribing a single dietary model. These may include partial substitution of animal-source foods, smaller portions, and increased consumption of legumes, whole grains, fruits, vegetables, nuts, and seeds. Even moderate reductions in meat and dairy consumption may produce meaningful environmental benefits when adopted across large populations. Financial and technical support for farmers and food producers is also important to ensure that the transition does not place a disproportionate burden on particular sectors or communities. In parallel, innovation in plant-based proteins and other alternative foods may expand the availability of sustainable, nutritionally appropriate, affordable, and culturally acceptable options (Mason-D’Croz et al., 2022).

7 Conclusion

This narrative review supports the premise that well-planned plant-based and plant-forward dietary transitions can contribute to the One Health agenda by addressing shared drivers of human, animal, and environmental health risks. The reviewed evidence indicates that reducing reliance on intensive animal-based food systems may lower pressures associated with zoonotic disease emergence, antimicrobial use in livestock production, greenhouse gas emissions, land-use change, freshwater consumption, nutrient pollution, biodiversity loss, and animal welfare concerns. At the same time, plant-based dietary patterns, when nutritionally adequate and based primarily on minimally processed plant foods, may support the prevention and management of major non-communicable diseases, including cardiovascular disease, type 2 diabetes, obesity, and some cancers.

Importantly, these benefits should not be interpreted as automatic consequences of any plant-based diet. Their realization depends on the quality and diversity of the diet, appropriate planning of nutrients such as vitamin B12, vitamin D, iron, calcium, iodine, zinc, and omega-3 fatty acids, and the sustainability of agricultural production and sourcing. Similarly, environmental benefits depend on whether reduced demand for animal products is accompanied by responsible land use, forest protection, restoration of degraded ecosystems, sustainable water management, and avoidance of burden shifting to environmentally damaging plant commodities or highly processed products.

Implementation therefore requires more than individual consumer choice. Real-world translation of plant-forward dietary transitions requires coordinated action across nutrition education, dietary guidelines, food procurement, agricultural policy, market incentives, food affordability, and public-health communication. Policies should support gradual, culturally acceptable dietary change, including partial substitution of animal-source foods, increased consumption of legumes, whole grains, fruits, vegetables, nuts, and seeds, and improved access to affordable, nutritionally adequate plant-based foods. Reform of agricultural subsidies and stronger integration of food policy into climate, biodiversity, antimicrobial resistance, and public health strategies may help align dietary recommendations with One Health goals.

Ultimately, plant-based and plant-forward diets should be viewed not as a universal or isolated solution, but as a practical demand-side component of broader One Health risk management. When combined with nutritional safeguards, sustainable production systems, responsible governance, and equitable implementation, they offer a feasible pathway to support human health, reduce pressures on animals and ecosystems, and strengthen the resilience of food systems in the face of climate, biodiversity, antimicrobial resistance, and public health challenges.

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